Accuracy of Diagnostic Mammography and Breast Ultrasound During Pregnancy and Lactation

Robbins, Jessica B.; Jeffries, Deborah O.; Roubidoux, Marilyn A.; Helvie, Mark A.

doi:10.2214/ajr.09.3662

Cited by 83 publications

(47 citation statements)

References 12 publications

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“…The lactating breast is under the influence of circulating hormones which lead to glandular proliferation, ductal dilatation, and stromal involution. Hence, the physical examination of the lactating breasts is difficult, and radiologic evaluation is usually necessary [5]. It has been suggested that, regardless of the lactational or gestational status, for symptomatic women younger than 30 years of age, US should be the first-line imaging and mammography should be saved for patients with indeterminate or suspicious lesions on US scans.…”

Section: Discussionmentioning

confidence: 99%

“…US is quite successful in demonstrating true masses as well as normal breast parenchyma which may show palpable nodularity during lactation. When necessary, mammography can be performed just after breastfeeding to avoid high-density parenchyma related to retained milk products [1,5]. Magnetic resonance imaging findings may be altered due to physiologic changes but remains an efficient technique for the detection and characterization of breast lesions during lactation.…”

Section: Discussionmentioning

confidence: 99%

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Breast Ultrasound during Lactation: Benign and Malignant Lesions

2018

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Background: Structural changes during lactation make breast physical examination difficult. When breast problems occur, patients are often referred for an ultrasound (US) scan. Most breast lesions diagnosed in these patients are benign, but the diagnosis of breast cancer is a challenge. We aim to demonstrate the spectrum of US imaging findings in lactating women. Methods: 77 breastfeeding patients who underwent breast US in our department between February 2012 and March 2017 were evaluated. Patients' electronic medical records were reviewed for the presenting complaint, US reports, pathology results if available, and clinical/radiologic follow-up. All examinations were performed by 2 radiologists. Results: 28 of the 77 patients had normal US findings. Cysts were seen in 16 patients. 4 patients had stable fibroadenomas. 6 patients had US imaging findings suggestive of mastitis, 5 patients had galactoceles, 1 patient had an abscess, and 1 patient had unilateral hypertrophy without any accompanying lesion. In 13 patients, BI-RADS 3 solid masses were diagnosed. Invasive breast cancer was diagnosed in 3 patients. Conclusion: US can demonstrate or exclude a true mass against the background of a nodular breast parenchyma. Radiologists must be aware of malignant US features to avoid delays in the diagnosis of pregnancy-associated breast cancer.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Breast Ultrasound during Lactation: Benign and Malignant Lesions

2018

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“…Ultrasound is the modality of choice for evaluating palpable masses, bloody nipple discharge, and focal pain in the lactating breast. Masses unique to the lactating breast include lactating adenomas and galactoceles [12].…”

Section: Lactation Changesmentioning

confidence: 99%

Breast Ultrasound Past, Present, and Future

Rapelyea¹,

Marks²

2018

Breast Imaging

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This chapter will review the utilization of breast ultrasound for screening and diagnostic purposes. Currently, ultrasound is primarily used to investigate palpable lesions in women less than 30 years old, to provide further characterization of abnormal mammographic findings, and to guide invasive breast interventions. Innovations in ultrasound technology have improved the detection and diagnosis of breast cancer. Computer-aided detection (CAD), elastography, quantitative breast ultrasound technology, and ultrasound contrast agents (microbubbles) were developed to improve diagnostic accuracy. These advancements have the potential to impact overall survival by detecting cancers that are smaller and less aggressive.

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“…Nodularity sensation by a physician or patient that lasts more than 2 to 4 weeks should be seriously taken and necessitates the use of imaging techniques (8). The most common manifestation of PABC is a painless mass discovered by the physician or patient (4,9). Other symptoms include unilateral breast enlargement accompanied by skin thickening, localized pain, and nipple discharge with or without mass or erythema, or even with distant metastasis and local invasion (10,11).…”

Section: Clinical Manifestationsmentioning

confidence: 99%

Pregnancy-associated Breast Cancer: A Review of Imaging Modalities

et al. 2018

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Context: The most common cancer and cause of cancer-related death in pregnant and breastfeeding patients is breast cancer. In the world, the incidence of pregnancy-associated breast cancer (P.A.B.C) is increasing, which is due to the fact that women delay their pregnancy up to the middle ages. According to the definition of P.A.B.C, a pregnancy-associated breast cancer is a case of breast cancer that occurs during pregnancy or up to 1 year after delivery. The aim of this paper is to review the clinical findings and novel imaging methods and findings, which help to diagnose pregnancy-associated breast cancer early. Evidence Acquisition: We reviewed the papers with subjects of PABC and imaging modalities in PABC by searching the medical and health databases such as PubMed, Google Scholar, as well as clinical trials. Results: The most frequent manifestation is a painless mass sensation. The most prevalent pathology of PABC is high-grade ductal carcinoma. The first diagnostic tool and most sensitive modality of imaging in this disease is ultrasound. Mammography during pregnancy and lactation is a safe method, which performs in symptomatic patients or in patients with positive ultrasound findings. MRI is not recommended during pregnancy, but it is completely harmless in breastfeeding patients and it is usually used as the complementary modality. Conclusions: Timely diagnosis of PABC requires complete knowledge of clinical symptoms and accurate interpreting of the images in different diagnostic modalities including mammography, ultrasound, and MRI. It should be noted that delay in diagnosis of PABC is the most common cause of low survival rate and bad prognosis.

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Accuracy of Diagnostic Mammography and Breast Ultrasound During Pregnancy and Lactation

Abstract: Among lactating and pregnant women, both mammography and sonography had a negative predictive value of 100% and accurately revealed the few cancers that were present in our study group.

Cited by 83 publications

References 12 publications

Breast Ultrasound during Lactation: Benign and Malignant Lesions

Breast Ultrasound during Lactation: Benign and Malignant Lesions

Breast Ultrasound Past, Present, and Future

Pregnancy-associated Breast Cancer: A Review of Imaging Modalities

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